WorkWell NYC Workshop Request Form

Thank you for your interest in scheduling a workshop for your worksite with WorkWell NYC! In this form, you'll be able to request health education workshops, as well as our pop-up fitness classes. You can see the full list of workshop options at this link: on.nyc.gov/2022workshops. Please submit one form per workshop you would like to request.

Primary Contact Name

Primary Contact Email

Primary Contact Phone Number

Secondary Contact Name

Secondary Contact Email

Secondary Contact Phone Number

Agency

Are you a WorkWell NYC Ambassador?

Workshop Name

Is this workshop mandatory for staff to attend?

What is your preference for workshop delivery?

Please note: Hybrid delivery means the instructor will be online and participants will have the option to join in-person or virtually. WorkWell NYC will provide the zoom link unless otherwise requested from the Ambassador.

Preferred workshop date and time (first choice):

Please allow a MINIMUM of 6 weeks and a MAXIMUM of 12 weeks notice from today. Requests made with less notice will not be fulfilled.

Preferred workshop date and time (second choice):

Please allow a MINIMUM of 6 weeks and a MAXIMUM of 12 weeks notice from today. Requests made with less notice will not be fulfilled.

By requesting a workshop, you are committing to: 1) Reserving a time, date, and location (if applicable) for the workshop 2) Confirming at least 25 registrants at least 5 businesses days prior to the workshop 3) Promoting the workshop with emails, flyers, word of mouth, etc. 4) Distributing the post-workshop evaluation 5) Providing registration and participation numbers to WorkWell NYC within three business days 6) In an effort to maximize resources and fill class size, any workshop with a video conference link will be added to our Open Workshop Calendar and be made available to other worksites to participate in.

By checking the box below, you agree to these terms and conditions.

Do you have any other information we should know about?

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If you spoke to a WorkWell NYC team member about this request, please include their name here:

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